Provider Demographics
NPI:1699339309
Name:KAI, JNAE (CNA, CPCT)
Entity type:Individual
Prefix:
First Name:JNAE
Middle Name:
Last Name:KAI
Suffix:
Gender:F
Credentials:CNA, CPCT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1130 ANGELIA DR SW
Mailing Address - Street 2:
Mailing Address - City:MABLETON
Mailing Address - State:GA
Mailing Address - Zip Code:30126-4806
Mailing Address - Country:US
Mailing Address - Phone:470-825-2115
Mailing Address - Fax:
Practice Address - Street 1:1130 ANGELIA DR SW
Practice Address - Street 2:
Practice Address - City:MABLETON
Practice Address - State:GA
Practice Address - Zip Code:30126-4806
Practice Address - Country:US
Practice Address - Phone:470-825-2115
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-04-28
Last Update Date:2019-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
372600000X, 246RP1900X, 374U00000X
GACN0030028904376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide
No372600000XNursing Service Related ProvidersAdult Companion
No246RP1900XTechnologists, Technicians & Other Technical Service ProvidersTechnician, PathologyPhlebotomy
No374U00000XNursing Service Related ProvidersHome Health Aide